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I think they're both full of shit about the ACA. Vance delivered lies and a nothing burger of a proposal. Walz said the system works. Pre and post trump it never worked. When it was mandatory, I was on the benefits cliff and couldn't afford the awful insurance that covered nothing (that also had an enormous deductible). I missed rent because of my state mandated health insurance. When trump made it voluntary, I had more money in my pocket and I still couldn't afford healthcare.
The ACA is fucked and needs to be replaced with a real socialized health system. Health insurance is corrupt and contrary to healthcare on a fundamental level. It should be abolished and outlawed.
The ACA was mostly designed by a republican (Mitt Romney). So it's designed to let companies keep making big profits on health care which should be never be for profit. Then some of the important stuff that would have made it more affordable got kicked out by the courts, such as letting states (including mine) choose not to expand medicaid which left many people unable to get either medicaid or ACA. Still even with all the problems, it's a hell of a lot better than things were before the ACA when millions of people with pre-existing conditions couldn't even get insurance at all. But like you say there is still a lot of corrupt shit going on in health care that needs fixed, such as "pharmacy benefit managers" jacking up drug prices and lining their own pockets 😠